June 28, 2012

New program to focus on effects of media exposure

Brian Primack, head of the Division of General Internal Medicine’s new program for research on media and health

Technological advances are making media content more compelling and more available than ever, says Brian Primack, who is leading the Division of General Internal Medicine’s new program for research on media and health (PROMH).

At one time, TV viewing was centered on the big three networks and primetime programming. Now people watch on their phones or computers, streaming content from sites such as Hulu.com.

At one time, to listen over and over to a favorite song, teens had to rewind tape or move the record player arm back to the edge of the vinyl disk. Today, digital music easily can be replayed countless times, and high-quality headphones keep parents from overhearing.

“You can download whatever you want, whenever you want,” Primack said, adding that as the barriers to exposure are falling, the influence of media is rising in conjunction with the increasing hours spent watching and listening.

The effects of media exposure aren’t universally negative, Primack said, noting that there are many potentially positive influences in TV, advertising, video games and movies.

“We ought to be using YouTube to get out public health messages,” he said.

“There are a lot of valuable things about media,” Primack said. “It can be entertaining, educational and can be used to promote positive health-related things.”

For instance, just a few decades ago, people with rare diseases couldn’t communicate easily with others who shared their condition. Now that the Internet has enabled individuals to develop social networks that span the globe, it’s easy to connect to that support online, he pointed out.

Studying media effects

Because media messages can have both positive and negative influences on health, research is needed to determine the effects of media — especially on young people — then find interventions that will lead to better health outcomes.

Primack’s research focuses on the influence of media such as television, advertising, video games, the Internet and movies on health outcomes including mental health, substance use and sexual behavior.

“We try to look at things that have the most public health impact,” said Primack, a faculty member in medicine and pediatrics who has been developing the mission and goals of the newly announced research program for several years.

Since 2006, Primack and his colleagues have published more than 50 research papers including studies on tobacco, marijuana and alcohol use; exposure to sexual and violent references in popular music lyrics, and the effects of media literacy on these behaviors.

Primack, who has a master’s degree in education and taught for four years before going to medical school, said he became keenly cognizant of how influential media are in kids’ lives as a junior high school teacher. During a year at an international school in West Africa, he began to ponder the effects after noticing how U.S. media were affecting the students even though they were thousands of miles away.

Collectively, tweens and teens have more exposure to media than other age groups and they tend to believe what they see. “They’re intellectual sponges at that age,” Primack said, citing a Kaiser Family Foundation report on media exposure that found kids ages 8-18 were exposed to an average of 8.5 hours a day of media messages.

How does that change kids’ brains? Their habits? How they think of themselves and the world?

Primack found research gaps in studying the influences of media content and exposure and set out to find answers.

As a family practice physician, Primack said he expected to pursue a clinical career. But after joining the School of Medicine faculty a decade ago, Primack began volunteering at local high schools to teach media literacy in a health context. The research bug bit, and he decided to study more formally how media literacy can influence health-related behaviors.

Primack took it upon himself to learn more about surveys and sampling techniques, eventually getting a grant to take courses through Pitt’s Institute for Clinical Research Education. His interest resulted in a PhD in clinical and translational science, which he completed last year here.

“I finally feel I have the tools to study this,” he said, calling the course work immediately applicable and valuable.

Rapid change

One disadvantage in the research world is the lengthy lead time it takes to get a study approved, funded and the results published. “There is a long pipeline,” he said, acknowledging that other industries don’t face the same constraints. “What we are writing today is relatively obsolete tomorrow,” he said.

For instance, many industries are capitalizing on the popularity of hookah smoking, yet there are few public health messages available on the effects of this form of tobacco use. “We are going to be behind the curve,” Primack said.

The value of media literacy

In light of the rapid change, he sees value in media literacy education to give young people the tools to think critically about the messages they’re receiving, regardless of the pop culture flavor of the month.

In English classes, for instance, it’s not unusual to analyze Shakespeare or other literature in terms of the social-historical context of the work. “We can do the same with an advertisement or movie or popular song: Who is behind making this?” Primack said, noting that educators often don’t think of analyzing advertisements, music or Internet content in a similar way.

For instance, seeing a movie star light up a cigarette after an exciting scene might send the message that smoking is a way to celebrate or relax. But a media-savvy viewer would be more apt to recognize that the fact that the character is smoking could have been paid for by the tobacco industry, he explained.

Likewise it’s important to consider who is behind the production of a song or advertisement, Primack said. “There are stars, but there are producers screening and deciding how they’ll get the most bang for their buck,” he said, pointing out that the star might not necessarily believe in what he or she is singing about or the product being advertised.

Some may argue for warning labels on certain media content, but those can easily be circumvented once that content turns up on YouTube, he warned.

“The concept of media literacy is a paradigm that can be applied to anything,” Primack said, adding that it can be applied to any medium ranging from the Gutenberg Bible to an advertisement on Facebook: Who made this? Why? What’s its purpose? What ideas is it conveying? How should it be interpreted? What production techniques were used? What is being omitted from the message? How does this affect me?

He is an advocate for the use of both education and policy to buffer negative health influences attributed to media.

In the case of younger children who lack the skills to evaluate, it may be developmentally appropriate to exert more control over the media messages they are receiving, Primack said. However, he falls overall on the less-protectionist side, preferring to empower kids to evaluate the media content they are bound to be exposed to.

Primack stressed that he avoids the policy arguments. “My purpose is not to be an advocate. I’m a researcher.” His role is to ask the questions and obtain data on the associations between exposures and health outcomes. It’s for others to determine what policies will maximize the positive and minimize the negative effects, he said.

What is certain is that media exposure is unavoidable and both positive and negative messages are possible. “You can’t pretend it’s not there,” he said.